{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:25:54Z","timestamp":1792520754927,"version":"4.5.0"},"reference-count":76,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Aflatoxins are mycotoxins produced by Aspergillus flavus and several other related organisms and are common contaminants of numerous grains and nuts, especially maize (corn) and peanuts. Although, undoubtedly, aflatoxins have been present in the food of humans for millennia, their toxic effects were not discovered until 1960, first becoming evident as a non-infectious outbreak of poisoning of turkeys (Turkey X disease) arising from contaminated groundnut meal. The elucidation of specific chemical structures in 1963 led to the rapid characterization of aflatoxins as among the most potent chemical carcinogens of natural origin ever discovered. As a frontispiece to the Special Issue \u201c65 Years on from Aflatoxin Discovery\u2014A Themed Issue in Honor of Professor John D. Groopman\u201d, we highlight many of Professor Groopman\u2019s important contributions utilizing urinary (aflatoxin\u2013N7\u2013guanine) and, especially, serum (aflatoxin\u2013albumin adducts) biomarkers; this work focused on over 40+ years of the development of analytical methods to measure biomarkers of aflatoxin exposure and their application in experimental and clinical studies. Collectively, this work serves as a template for using chemical-specific biomarkers as key tools to probe \u2018exposure\u2013disease relationships\u2019\u2014in this instance, dietary aflatoxins and liver cancer. New approaches to measuring carcinogen biomarkers will build upon this \u2018aflatoxin paradigm\u2019 to inform the public health implications of diverse exposures around the world.<\/jats:p>","DOI":"10.3390\/toxins16110496","type":"journal-article","created":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T07:51:15Z","timestamp":1732002675000},"page":"496","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["65 Years on\u2014Aflatoxin Biomarkers Blossoming: Whither Next?"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6676-261X","authenticated-orcid":false,"given":"Thomas W.","family":"Kensler","sequence":"first","affiliation":[{"name":"Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3121-1380","authenticated-orcid":false,"given":"David L.","family":"Eaton","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"ref_1","first-page":"55","article-title":"Turkey \u201cX\u201d Disease. 1961, 9, 55\u201358","volume":"9","author":"Blount","year":"1961","journal-title":"J. Br. Turkey"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Pickova, D., Ostry, V., Toman, J., and Malir, F. (2021). Aflatoxins: History, Significant Milestones, Recent Data on Their Toxicity and Ways to Mitigation. Toxins, 13.","DOI":"10.3390\/toxins13060399"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/S0007-1935(17)42453-5","article-title":"Groundnut Toxicity in Poultry: Turkey X Disease","volume":"119","author":"Wannop","year":"1963","journal-title":"Br. Vet. J."},{"key":"ref_4","unstructured":"Eaton, D.L., and Groopman, J.D. (1994). Acute Hepatotoxicity of Aflatoxins. The Toxicology of Aflatoxins: Human Health, Veterinary and Agricultural Significance, Academic Press, Inc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1038\/1951060a0","article-title":"Aspergillus Flavus and Turkey X Disease: Isolation in Crystalline Form of a Toxin Responsible for Turkey X-Disease","volume":"195","author":"Koelensmid","year":"1962","journal-title":"Nature"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1021\/ja01082a031","article-title":"the Structures of Aflatoxins B and G","volume":"87","author":"Asao","year":"1965","journal-title":"J. Am. Chem. Soc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1038\/1951062a0","article-title":"Aspergillus Flavus and Turkey X Disease. Toxic Metabolites of Aspergillus Flavus","volume":"195","author":"Nesbitt","year":"1962","journal-title":"Nature"},{"key":"ref_8","unstructured":"Eaton, D.L., and Groopman, J.D. (1994). Carcinogenicity of Aflatoxins in Nonmammalian Organisms. The Toxicology of Aflatoxins: Human Health, Veterinary and Agricultural Significance, Academic Press, Inc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1038\/bjc.1961.92","article-title":"Liver Changes and Primary Liver Tumours in Rats given Toxic Guinea Pig Diet (M.R.C. Diet 18)","volume":"15","author":"Schoental","year":"1961","journal-title":"Br. J. Cancer"},{"key":"ref_10","first-page":"50","article-title":"Toxic Products in Groundnuts. Biological Effects","volume":"2","author":"Allcroft","year":"1963","journal-title":"Chem. Ind."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1038\/2021016a0","article-title":"Carcinogenic Activity of Aflatoxin to Rats","volume":"202","author":"Barnes","year":"1964","journal-title":"Nature"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1038\/bjc.1963.89","article-title":"Toxic Effects of Groundnut Meal Containing Aflatoxin to Rats and Guinea-Pigs","volume":"17","author":"Butler","year":"1963","journal-title":"Br. J. Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1038\/208308a0","article-title":"Hepatic tumours in ducks fed a low level of toxic groundnut meal","volume":"208","author":"Carnaghan","year":"1965","journal-title":"Nature"},{"key":"ref_14","first-page":"2370","article-title":"Dose-response characteristics of aflatoxin B1 carcinogenesis in the rat","volume":"27","author":"Wogan","year":"1967","journal-title":"Cancer Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1038\/1921095a0","article-title":"Toxicity Associated with Certain Samples of Groundnuts","volume":"192","author":"Lancaster","year":"1961","journal-title":"Nature"},{"key":"ref_16","first-page":"962","article-title":"Effects of cirrhosis and other liver insults on induction of liver tumors by aflatoxin in rats","volume":"15","author":"Newberne","year":"1966","journal-title":"Lab. Investig."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/0015-6264(74)90239-9","article-title":"Carcinogenic effects of low dietary levels of aflatoxin B1 in rats","volume":"12","author":"Wogan","year":"1974","journal-title":"Food Cosmet. Toxicol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"114498","DOI":"10.1016\/j.fct.2024.114498","article-title":"Risk characterization of N-nitrosodimethylamine in pharmaceuticals","volume":"186","author":"Paustenbach","year":"2024","journal-title":"Food Chem. Toxicol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1038\/227403a0","article-title":"Aflatoxin M1 in human urine","volume":"227","author":"Campbell","year":"1970","journal-title":"Nature"},{"key":"ref_20","first-page":"139","article-title":"Molecular dosimetry of aflatoxin DNA adducts in humans and experimental rat models","volume":"374","author":"Groopman","year":"1992","journal-title":"Prog. Clin. Biol. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"6492","DOI":"10.1073\/pnas.82.19.6492","article-title":"Aflatoxin metabolism in humans: Detection of metabolites and nucleic acid adducts in urine by affinity chromatography","volume":"82","author":"Groopman","year":"1985","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1093\/carcin\/11.11.2063","article-title":"The aflatoxin-lysine adduct quantified by high-performance liquid chromatography from human serum albumin samples","volume":"11","author":"Sabbioni","year":"1990","journal-title":"Carcinogenesis"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1021\/tx960161+","article-title":"Synthesis and characterization of aflatoxin B1 mercapturic acids and their identification in rat urine","volume":"10","author":"Scholl","year":"1997","journal-title":"Chem. Res. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1158\/1055-9965.EPI-05-0890","article-title":"Quantitative comparison of aflatoxin B1 serum albumin adducts in humans by isotope dilution mass spectrometry and ELISA","volume":"15","author":"Scholl","year":"2006","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1093\/carcin\/14.6.1203","article-title":"Quantitative analysis of aflatoxin-albumin adducts","volume":"14","author":"Sheabar","year":"1993","journal-title":"Carcinogenesis"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1021\/tx010063a","article-title":"Liquid chromatography electrospray-mass spectrometry of urinary aflatoxin biomarkers: Characterization and application to dosimetry and chemoprevention in rats","volume":"14","author":"Walton","year":"2001","journal-title":"Chem. Res. Toxicol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1016\/0006-291X(74)90417-3","article-title":"Aflatoxin B1-2,3-oxide: Evidence for its formation in rat liver in vivo and by human liver microsomes in vitro","volume":"60","author":"Swenson","year":"1974","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1073\/pnas.75.4.1745","article-title":"Identification of the principal aflatoxin B1-DNA adduct formed in vivo in rat liver","volume":"75","author":"Croy","year":"1978","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1073\/pnas.74.5.1870","article-title":"Structural identification of the major DNA adduct formed by aflatoxin B1 in vitro","volume":"74","author":"Essigmann","year":"1977","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_30","first-page":"172","article-title":"Aflatoxin B1-2,3-oxide as a probable intermediate in the covalent binding of aflatoxins B1 and B2 to rat liver DNA and ribosomal RNA in vivo","volume":"37","author":"Swenson","year":"1977","journal-title":"Cancer Res."},{"key":"ref_31","first-page":"650","article-title":"Excretion of an aflatoxin-guanine adduct in the urine of aflatoxin B1-treated rats","volume":"41","author":"Bennett","year":"1981","journal-title":"Cancer Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/carcin\/13.1.101","article-title":"Molecular dosimetry of urinary aflatoxin-N7-guanine and serum aflatoxin-albumin adducts predicts chemoprotection by 1,2-dithiole-3-thione in rats","volume":"13","author":"Groopman","year":"1992","journal-title":"Carcinogenesis"},{"key":"ref_33","first-page":"221","article-title":"Molecular dosimetry of aflatoxin-N7-guanine in human urine obtained in The Gambia, West Africa","volume":"1","author":"Groopman","year":"1992","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_34","first-page":"267","article-title":"Molecular dosimetry in rat urine of aflatoxin-N7-guanine and other aflatoxin metabolites by multiple monoclonal antibody affinity chromatography and immunoaffinity\/high performance liquid chromatography","volume":"52","author":"Groopman","year":"1992","journal-title":"Cancer Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1158\/1940-6207.CAPR-13-0430","article-title":"Complete protection against aflatoxin B(1)-induced liver cancer with a triterpenoid: DNA adduct dosimetry, molecular signature, and genotoxicity threshold","volume":"7","author":"Johnson","year":"2014","journal-title":"Cancer Prev. Res."},{"key":"ref_36","first-page":"3924","article-title":"Modulation of aflatoxin metabolism, aflatoxin-N7-guanine formation, and hepatic tumorigenesis in rats fed ethoxyquin: Role of induction of glutathione S-transferases","volume":"46","author":"Kensler","year":"1986","journal-title":"Cancer Res."},{"key":"ref_37","first-page":"5501","article-title":"Protection against aflatoxin B1-induced hepatocarcinogenesis in F344 rats by 5-(2-pyrazinyl)-4-methyl-1,2-dithiole-3-thione (oltipraz): Predictive role for short-term molecular dosimetry","volume":"51","author":"Roebuck","year":"1991","journal-title":"Cancer Res."},{"key":"ref_38","first-page":"57","article-title":"Dietary chlorophyllin is a potent inhibitor of aflatoxin B1 hepatocarcinogenesis in rainbow trout","volume":"55","author":"Breinholt","year":"1995","journal-title":"Cancer Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1021\/tx00046a004","article-title":"Mechanisms of chlorophyllin anticarcinogenesis against aflatoxin B1: Complex formation with the carcinogen","volume":"8","author":"Breinholt","year":"1995","journal-title":"Chem. Res. Toxicol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"14601","DOI":"10.1073\/pnas.251536898","article-title":"Chlorophyllin intervention reduces aflatoxin-DNA adducts in individuals at high risk for liver cancer","volume":"98","author":"Egner","year":"2001","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1093\/jnci\/91.4.347","article-title":"Protective alterations in phase 1 and 2 metabolism of aflatoxin B1 by oltipraz in residents of Qidong, People\u2019s Republic of China","volume":"91","author":"Wang","year":"1999","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1021\/jasms.2c00314","article-title":"Global Discovery and Temporal Changes of Human Albumin Modifications by Pan-Protein Adductomics: Initial Application to Air Pollution Exposure","volume":"34","author":"Smith","year":"2023","journal-title":"J. Am. Soc. Mass. Spectrom."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1093\/carcin\/8.6.819","article-title":"Isolation and characterization of the major serum albumin adduct formed by aflatoxin B1 in vivo in rats","volume":"8","author":"Sabbioni","year":"1987","journal-title":"Carcinogenesis"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1093\/carcin\/9.7.1323","article-title":"Serum albumin adducts in the molecular epidemiology of aflatoxin carcinogenesis: Correlation with aflatoxin B1 intake and urinary excretion of aflatoxin M1","volume":"9","author":"Gan","year":"1988","journal-title":"Carcinogenesis"},{"key":"ref_45","first-page":"229","article-title":"Dietary intake of aflatoxins and the level of albumin-bound aflatoxin in peripheral blood in The Gambia, West Africa","volume":"1","author":"Wild","year":"1992","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/carcin\/20.1.1","article-title":"The light at the end of the tunnel for chemical-specific biomarkers: Daylight or headlight?","volume":"20","author":"Groopman","year":"1999","journal-title":"Carcinogenesis"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1093\/toxsci\/kfq283","article-title":"Aflatoxin: A 50-year odyssey of mechanistic and translational toxicology","volume":"120","author":"Kensler","year":"2011","journal-title":"Toxicol. Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1158\/1055-9965.EPI-07-2926","article-title":"Long-term stability of human aflatoxin B1 albumin adducts assessed by isotope dilution mass spectrometry and high-performance liquid chromatography-fluorescence","volume":"17","author":"Scholl","year":"2008","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1152\/physrev.00023.2017","article-title":"The KEAP1-NRF2 System: A Thiol-Based Sensor-Effector Apparatus for Maintaining Redox Homeostasis","volume":"98","author":"Yamamoto","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1021\/tx980185b","article-title":"Development of cancer chemopreventive agents: Oltipraz as a paradigm","volume":"12","author":"Kensler","year":"1999","journal-title":"Chem. Res. Toxicol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1158\/1940-6207.CAPR-14-0119","article-title":"Of mice, rats, and men: Could Nrf2 activation protect against aflatoxin heptocarcinogenesis in humans?","volume":"7","author":"Eaton","year":"2014","journal-title":"Cancer Prev. Res."},{"key":"ref_52","first-page":"603","article-title":"Predictive value of molecular dosimetry: Individual versus group effects of oltipraz on aflatoxin-albumin adducts and risk of liver cancer","volume":"6","author":"Kensler","year":"1997","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_53","first-page":"3","article-title":"A follow-up study of urinary markers of aflatoxin exposure and liver cancer risk in Shanghai, People\u2019s Republic of China","volume":"3","author":"Qian","year":"1994","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/0140-6736(92)91528-G","article-title":"Urinary aflatoxin biomarkers and risk of hepatocellular carcinoma","volume":"339","author":"Ross","year":"1992","journal-title":"Lancet"},{"key":"ref_55","unstructured":"IARC (1993). Some Naturally Occurring Substances: Food Items and Constituents, Heterocyclic Aromatic Amines and Mycotoxins, IARC Press."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/hep.510240108","article-title":"Elevated aflatoxin exposure and increased risk of hepatocellular carcinoma","volume":"24","author":"Chen","year":"1996","journal-title":"Hepatology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1002\/(SICI)1097-0215(19960904)67:5<620::AID-IJC5>3.0.CO;2-W","article-title":"Aflatoxin exposure and risk of hepatocellular carcinoma in Taiwan","volume":"67","author":"Wang","year":"1996","journal-title":"Int. J. Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Chen, J.G., Kensler, T.W., Zhu, J., Zhu, Y.R., Wang, J.B., Lu, J.H., Munoz, A., and Groopman, J.D. (2024). Profound primary prevention of liver cancer following a natural experiment in China: A 50-year perspective and public health implications. Int. J. Cancer.","DOI":"10.1002\/ijc.35198"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1038","DOI":"10.1158\/1940-6207.CAPR-13-0168","article-title":"Reduced aflatoxin exposure presages decline in liver cancer mortality in an endemic region of China","volume":"6","author":"Chen","year":"2013","journal-title":"Cancer Prev. Res."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1289\/ehp.9302","article-title":"Workgroup report: Public health strategies for reducing aflatoxin exposure in developing countries","volume":"114","author":"Strosnider","year":"2006","journal-title":"Environ. Health Perspect."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1136\/bmj.325.7354.20","article-title":"Dietary aflatoxin exposure and impaired growth in young children from Benin and Togo: Cross sectional study","volume":"325","author":"Gong","year":"2002","journal-title":"BMJ"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Smith, J.W., Ng, D.K., Alvarez, C.S., Egner, P.A., Burke, S.M., Chen, J.G., Kensler, T.W., Koshiol, J., Rivera-Andrade, A., and Kroker-Lobos, M.F. (2022). Assessing the Validity of Normalizing Aflatoxin B(1)-Lysine Albumin Adduct Biomarker Measurements to Total Serum Albumin Concentration across Multiple Human Population Studies. Toxins, 14.","DOI":"10.3390\/toxins14030162"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.fct.2014.09.016","article-title":"Aflatoxin exposure during the first 1000 days of life in rural South Asia assessed by aflatoxin B(1)-lysine albumin biomarkers","volume":"74","author":"Groopman","year":"2014","journal-title":"Food Chem Toxicol"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/ije\/dyr236","article-title":"The exposome: From concept to utility","volume":"41","author":"Wild","year":"2012","journal-title":"Int. J. Epidemiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/toxsci\/kft251","article-title":"The nature of nurture: Refining the definition of the exposome","volume":"137","author":"Miller","year":"2014","journal-title":"Toxicol. Sci."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1158\/1055-9965.EPI-07-2780","article-title":"Human aflatoxin albumin adducts quantitatively compared by ELISA, HPLC with fluorescence detection, and HPLC with isotope dilution mass spectrometry","volume":"17","author":"McCoy","year":"2008","journal-title":"Cancer Epidemiol. Biomarkers Prev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.cca.2013.04.011","article-title":"Serum concentrations of an aflatoxin-albumin adduct in the National Health and Nutrition Examination Survey (NHANES) 1999\u20132000","volume":"423","author":"Schleicher","year":"2013","journal-title":"Clin. Chim. Acta"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"113662","DOI":"10.1016\/j.ijheh.2020.113662","article-title":"Increase in aflatoxin exposure in two populations residing in East and West Texas, United States","volume":"231","author":"Xue","year":"2021","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.toxrep.2019.05.009","article-title":"Association between aflatoxin-albumin adduct levels and tortilla consumption in Guatemalan adults","volume":"6","author":"Alvarez","year":"2019","journal-title":"Toxicol. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Wang, S., Pan, D., Zhang, T., Su, M., Sun, G., Wei, J., Guo, Z., Wang, K., Song, G., and Yan, Q. (2020). Corn Flour Intake, Aflatoxin B(1) Exposure, and Risk of Esophageal Precancerous Lesions in a High-Risk Area of Huai\u2019an, China: A Case-Control Study. Toxins, 12.","DOI":"10.3390\/toxins12050299"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1038\/s41370-018-0066-5","article-title":"Aflatoxin exposure in children living in Mirpur, Dhaka: Data from MAL-ED companion study","volume":"29","author":"Mahfuz","year":"2019","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3361","DOI":"10.1017\/S1368980020001421","article-title":"Aflatoxin exposure was not associated with childhood stunting: Results from a birth cohort study in a resource-poor setting of Dhaka, Bangladesh","volume":"24","author":"Mahfuz","year":"2021","journal-title":"Public. Health Nutr."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1289\/ehp.8384","article-title":"Case-control study of an acute aflatoxicosis outbreak, Kenya, 2004","volume":"113","author":"Lindblade","year":"2005","journal-title":"Environ. Health Perspect."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"nzab153","DOI":"10.1093\/cdn\/nzab153","article-title":"Longitudinal Assessment of Prenatal, Perinatal, and Early-Life Aflatoxin B(1) Exposure in 828 Mother-Child Dyads from Bangladesh and Malawi","volume":"6","author":"Smith","year":"2022","journal-title":"Curr. Dev. Nutr."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Carlsson, H., Rappaport, S.M., and Tornqvist, M. (2019). Protein Adductomics: Methodologies for Untargeted Screening of Adducts to Serum Albumin and Hemoglobin in Human Blood Samples. High. Throughput, 8.","DOI":"10.3390\/ht8010006"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1158\/0008-5472.CAN-13-3178","article-title":"Urinary tobacco smoke-constituent biomarkers for assessing risk of lung cancer","volume":"74","author":"Yuan","year":"2014","journal-title":"Cancer Res."}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/11\/496\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:34:34Z","timestamp":1760114074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/16\/11\/496"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,18]]},"references-count":76,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["toxins16110496"],"URL":"https:\/\/doi.org\/10.3390\/toxins16110496","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,18]]}}}